Vitamin A Supplementation for Prevention EDIT

VITAMIN A SUPPLEMENTATION FOR PREVENTION OF BRONCHOPULMONARY DYSPLASIA DR.. "Vitamin A status of neonates with bronchopulmonary dysplasia." Pediatric research 19.2 1985 2... "Vitamin A

VITAMIN A SUPPLEMENTATION FOR PREVENTION

OF BRONCHOPULMONARY DYSPLASIA

DR VU THI MAI UYEN

Vitamin A

 Involved in the regulation of lung development and

injury repair.

 Low levels associated with increased BPD.

1 Shenai, Jayant P., Frank Chytil, Mildred T Stahlman "Vitamin A status of neonates with bronchopulmonary dysplasia." Pediatric research 19.2 (1985)

2 Tyson, Jon E., et al "Vitamin A supplementation for extremely-low-birth-weight infants." New England journal of medicine 340.25 (1999): 1962-1968.

Darlow, Brian A., and P J Graham "Vitamin A supplementation to prevent mortality and short‐and long‐term morbidity in very low birthweight infants."

The Cochrane Library (2011).

 Long-term follow-up of infants at 18–22 months could not demonstrate any improvement in mortality, neurodevelopmental impairment, or respiratory

outcomes from treatment with Vitamin A.

Ambalavanan, Namasivayam, et al "Vitamin A supplementation for extremely low birth weight infants: outcome at 18 to 22 months." Pediatrics 115.3

(2005): e249-e254

Conclusion: Whether clinicians decide to utilize repeat intramuscular doses of vitamin A to prevent chronic lung disease may depend upon the local incidence

of this outcome and the value attached to achieving a modest reduction in this outcome, balanced against the lack of other proven benefits and the acceptability

of treatment Information on long-term neurodevelopmental status suggests no evidence of either benefit or harm from the intervention.

Chabra, Shilpi, et al "Vitamin A status after prophylactic intramuscular vitamin A supplementation in extremely low birth weight infants." Nutrition in

Clinical Practice (2013): 0884533613479132.

Tolia, Veeral N., et al "The effect of the national shortage of vitamin A on death or chronic lung disease in extremely low-birth-weight infants."

JAMA pediatrics 168.11 (2014): 1039-1044.

Tolia, Veeral N., et al "The effect of the national shortage of vitamin A on death or chronic lung disease in extremely low-birth-weight

infants." JAMA pediatrics 168.11 (2014): 1039-1044.

Gawronski, Catherine A., and Kristen M Gawronski "Vitamin A Supplementation for Prevention of Bronchopulmonary Dysplasia Cornerstone of Care or

Futile Therapy?." Annals of Pharmacotherapy (2016): 1060028016647066.

Route & dosage

 Mostly IM.

 2000 IU IM every other day for 28 days.

 5000 IU IM 3 times weekly for 4 weeks.

Gawronski, Catherine A., and Kristen M Gawronski "Vitamin A Supplementation for Prevention of Bronchopulmonary Dysplasia Cornerstone of Care or

Futile Therapy?." Annals of Pharmacotherapy (2016): 1060028016647066.

 BPD still remains a very important complication of neonatal intensive care.

• Vitamin A have been shown to reduce the incidence of BPD.

 Little is known about the optimal intake or the mode of VA delivery in

preterm infants, especially in ELBW babies.